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MP21-128
(-�yE DR �. O` CLu y`1y'J Y . 19 t� � 0 VILLAGE OF RYE BROOK MAYOR 938 King Street,Rye Brook,N.Y. 10573 ADMINISTRATOR Jason A.Klein (914)939-0668 Christopher J.Bradbury www.iyebrook.org TRUSTEES BUILDING & FIRE INSPECTOR Susan R. Epstein Steven E. Fews Stephanie J.Fischer David M. Heiser Salvatore W.Morlino CERTIFICATE OF COMPLIANCE November 17,2023 Guang Chen&Xijinyan Chen 174 Ivy Hill Crescent Rye Brook,New York 10573 Re: 174 Ivy Hill Crescent,Rye Brook,New York 10573 Parcel ID#: 129.76-1-39 This document certifies that the work done under Mechanical Permit #21-128 issued on 9/9/2021 for the installation of a new oil fired boiler and new hot water heater has been satisfactorily completed. Sincerely, Steven E. Fews Building&Fire Inspector /to BRC��• O 2m cu � Q�i� ��O•c • 19f32• BUILDING DEPARTMENT ❑BUILDING INSPECTOR ❑ASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK ❑CODE ENFORCEMENT OFFICER 938 King Street • Rye Brook,NY 10573 (914) 939-0668 FAx (914) 939-5801 www ryebrook.org - - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - - -�ADDRESS :— 1— 1 \ ' t - (!!�' DATE' r . i PERMIT# t '+� ISSUED: C' L SECT: BLOCK: LOT: LOCATION: c '� 4 OCCUPANCY: ❑ Violation Noted THE WORK IS... ❑ PASSED ❑ FAILED REINSPECTION ❑ SITE INSPECTION REQUIRED ❑ FOOTING ❑ FOOTING DRAINAGE ❑ FOUNDATION ❑ UNDERGROUND PLUMBING NOTES ON INSPECTION: ❑ ROUGH PLUMBING ❑ ROUGH FRAMING ❑ INSULATION ❑ Natural Gas ❑ L.P. Gas ❑ FUEL TANK ❑ FIRE SPRINKLER ❑ FINAL PLUMBING ❑ CROSS CONNECTION FINAL ❑ OTHER O • • Durable cast iron heat I exchanger design • Easy to install and service Made with I d } � r� HIGH EFFICIENCY CAST IRON BOILER T M a. GOLD SERIES OIL BOILERS APPLICATIONS INCLUDE: v Residential . w Light Commercial `y Multiple Boilers If Ic .z.'_�..® adK0 + _ 7-S j aa;.'a �rraa .nxu .ve +xzac .s?.- Indirect-fired Water Heating U..a.m m ^ Radiant Heating ' o o a ...And Much More 'ENERGY STAR' requires a minimum of 87%AFUE,which is only achieved by these models by reducing the burner rate and installing the optional ENERGY STAR vent damper kit. See Ratings chart on next page. DIMENSIONS ...� STANDARD EQUIPMENT: r ," °" _ ■ Factory Tested and Assembled Fo, Cast Iron Section Assembly +a,e. I# (jacket and collector hood are eex a '! i 291. a...__.._ ; not assembled on 7,8,and 9 section blocks) 15lN' M - - ■ Aluminized Steel Flue Collector IMW swe A•WGOFmnt Sock Intermadlete Hood with Flue Cap on Top `coy°e ■N ao`c� Outlet (convertible to rear outlet) Nm �QQ ■ Swing-Away Burner °.° y � c,°�° Mounting Door 77/ ■ Refractory Blanket and Target B2 1'/2 Alternate return—"A"units only Wall in Combustion Area E3 Yz Pressure/temperature gauge ■ Circulator(when ordered) H z Drain Valve L � 3/4 High limit/circulator control Sizes 2-4:Taco 007e N I %2 Piping to expansion tank or automatic air vent - Sizes 5-6:Taco 007 R 3�4 Relief valve ■ High Limit Control with Circulator Relay, LWCO Function,and Supply"C"(inches) j Dimension(Inches) integrated service switch ■ Two Vent Pipe Brackets ■ Pressure/Temperature Gauge �° Q Q■ m ■ 30 PSIG ASME Relief Valve WGO-2 1'/<(circulator flange) i 1'/2 1'/2 10'/2 13 3/4 PSIG working pressure) WG0-3 1'/4(circulator flange) 1'h 1 Y2 13 V2 16 Ye ■ Drain Valve WGO-4 1'/4(circulator flange) 1 '11: 1 v2 13 1/e 16% ■ Barometric Damper WGO-S 1 v4(circulator flange) 1 i2 1 v2 16 pie 20 ■ Built-in Air Separator WGO-6 1'/4(circulator flange) 1'/2 1+/: 20 23 Ye WGo-7 not applicable 11/2 1'/2 231/e 26Y4 WGO-8 not applicable 1'/2 1 %2 26'/4 29% WGO-9 not applicable 11/2 11/2 29% 32'/z OPTIONAL EQUIPMENT: RATINGS ■ High-Efficiency Flame-Retention Burner AHRI Minimum / Oil Burner(Beckett AFG, Carlin Input certified chimney EZ or Rieilo).Specify 2-Stage Fuel i Rating Ratings o, size Unit(optional) if Required. i Q, 40 .Q�' ■ Vent Damper Kit A °yN V ` `t y V W-M 5&10 Year Homeowner QQ Protection Plan N+r nn +,.,4 __1 c:.-_ • WG0-2RD 0.70 98 i 86 75 87.0 .010 8x8 6 15 i 540 NOTES: i WGo-2 0.70 98 i 86 75 86.4 .010 8x8 6 15 j 540 Add"P"for packaged boiler(WGO- • WG0-3RD 0.80 112 98 85 87.0 .010 8x8 6 15 595 2 through WGO-6 only).Add"A"for j I WGo-3 0.95 133 115 100 85.3 .020 8X8 6 15 ! 595 boiler only(WGO-2 through WGO-9). QWGO-4RD 1.00 140 123 107 87.0 .010 8x8 6 15 645 (1) No.2 fuel oil-Commercial Standard WGO-4 1.20 168 1 145 126 85.0 .010 SX8 6 15 645 Specification CS75-56.Heating value • WGO-SRD of oil-140,000 BTU/Gal. 1.20 168 148 129 87.0 .015 8X8 7 15 760 (2) Based on standard test procedures WGo-s 1.45 203 175 152 85.0 .015 8X8 7 15 760 prescribed by the United States WGO-6RD 1.40 196 173 150 87.0 .015 8X8 7 15 j 860 Department of Energy at combustion WGO-6 1.75 245 212 I 184 .85.0 .015 8X8 7 15 860 condition of 13.5%CO2 and-0.02" WGO-7RD 1.60 224 197 ' 171 87.0 .015 8X8 8 15 930 W.C.draft. I wGo-7 2,00 280 242 210 85.0 .015 8X8 8 15 930 (3) MBH refers to thousands of BTU wGo-a 2.30 1 322 266 231 .025 8X72 g 20 1030 per hour. WGo-9 2.55 357 1 295 257 - 030 8X12 ( 8 20 1 1135 I (4) Net AHRI ratings are based on net "ENERGY STAR'compliant with Version 3.0 Boiler Specification of 87%AFUE only when installed installed radiation adequate for the at the reduced burner rate(R)and with the optional vent damper kit(D).Burners shipped with requirements of the building, including standard rate nozzle,reduced rates achieved through nozzle change-refer to burner instructions or a piping and pickup allowance of boiler's rating label for correct selection. 1.15-sufficient for normal conditions. In the interest of continual improvernents in product and performance,Weil-McLain reserves Provide additional allowance only for the right to change specifications without notice. Unusual piping and pick up loads. WM7905_BRO_018_WGO � ( S1im 1 INEF• DOE Oka W, Advanced Heating & Hot Water Systems www. htproducts.com r 316L Stainless Steel Indirects & Storage Tanks GREAT WARRANTY RESISTS SCALE BUILD UP LIGHT WEIGHT A BRAND OF C21 ARiSTON THERMO USA Stainless Steel Internal " Bent Hot Water Outlet Tube —Extracts 5—796 316L Stainless Steel Tank NSF more hot water off the for High Temperatures& top of the tank dome Corrosion Resistance Attractive silver finish---� cover that resists Environmentally Safe, dents and corrosion CFC Free Water Blown, #01 2"Thick Foam High Output Finned Insulation allows - less than 1/2 Degree F Cupronickel Heat -� OPTIONAL EQUIPMENT Exchanger Provides heat loss per hour Maximum Efficiency Aquastat Control 1 1 Fins per inch -Thermostatic Mixing Valve g Immersion Type Stainless Bronze Pump Steel Control Well STANDARD FEATURES 431.. I� 316L Stainless Steel �` -- 1"Boiler Supply Connection Finned 90/10 Cupronickel Heat Exchanger Stainless Steel Cold Stainless Steel Aquastat Well Water Inlet 1"Boiler Return Connection Dimensions & Specifications -- � t C• A011 fa S1 S2 ---- — e." S2 R2 p E E - S1 F Rl R2 . F B ��� R1 A B C D E F G m Model Floor to Capacity Ex pp g Exchanger Heat Shipping Dimensions Diameter Domestic Boiler Floor to Boiler Supply Floor to Boiler Domestic Surface weight Ht Connections Connections Return Out SSU-20N 27" 19 1/4" 3/4" 1"NPT S1-9 3/4" 111-5 1/4" 22" 20 15 SQ FT 51 LBS SSU-30N 39 112" 19 1;I' 3/4" 1"NPT S1-9 3/4" R1-5 1/4" 34" 30 15 SQ FT 62 LBS SSU-30LBN 28 1/2" 23 1/4" 3/4" 1"NPT Sl-9 3/4" R1-5 1/4" 22" 30 15 SQ FT 71 LBS SSU- 52 1/2" 19 1/4" 3/4" 1"NPT S1-9 3/4" 111-5 1/4" 46" 45 20 SQ FT 72 LBS SSU-60N 52 1/2" 23 1/4" i" 1"NPT Sl-9 3/4" R1-5 1/4" 46" 60 20 SQ FT 109 LBS SSU-80N 72" 23 1/4" 1 1/2" 1"NPT S1-29" RI-6" 64 3/4" 80 34 SQ FT 143 LBS SSU-119N 74" 27" 1 1/2" 1"NPT 51-30 1/4" R1-7 114" F5" 110 -M Cr)rT )!-,i nc SSU-45CN 42 23 1/4" 3/4" 1"NPT S1-9 3/4" S2-18 3/4" R1-51/4" R2-14" 35" 45 40 SQ FT 106 LBS SSU-60CN 52 1/2" 23 1/4" 1" 1"NPT Sl-9 3/4" S2-18 3/4" Rl-5 1/4" 112-14" 46" 60 40 SQ FT 126 LBS SSU-80CN 72" 23 1/4" 11/2" 1"NPT S1-29" 52-29" Rl-6" R2-6" 64 3/4" 80 68 SQ F1 175 LBS SSU-119CN 74" 27" 1 1/2" 1"NPT S1-301/4"1 S2-30 1/4" R1-71/4" 112-71/4" 66" 119 68 SQ FT 242 LBS www.htproducts.com • 272 Duchaine Blvd, New Bedford, MA • 0( Ariston I hermo USA LLC. 06/18/2021 • MKILl1-111 In accordance with our company policy of ongoing product improvement,HTP reserves the right to make changes without prior notice.•Preliminary product specifications ..:... ... ----- RNi. A • CN cz C\j ............. M. CN 0 (N U ... ...... ISr 0 -0 LLJ C LIJ In rj) LU C) c'Jon 0 CO :D 0 Li = .;-; L) U) LLJ SI- C4 e*K LLJ Z A f a 41 ........... 2; . ......... E z (D co .14 o I.T'z Pr— E 1 O .( S i3 4 q • N 0mO MR 47Azwv A - 40 y pi p v1 . a, ft�q m .'Z A Kr' CERTIFICATE OF LIABILITY INSURANCE DATE12/10 DMlYY) v1o/2ozo THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. CONT PRODUCER NAME:CTCLIENT CONTACT CENTER FEDERATED MUTUAL INSURANCE COMPANYAX HOME OFFICE: P.O.BOX 328 A/OCNNo EXt:8�333-4949 FA/C No:507-446.4664 OWATONNA,MN 55060 EAI�ESS.CLIENTCONTACTCENTER FEDINS.COM INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED 286-468-4 INSURER a FEDERATED RESERVE INSURANCE COMPANY 16024 ARCTIC MECHANICAL INCORPORATED INSURERC: 460 N MAIN ST PORT CHESTER,NY 10573-3310 INSURER D. INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:90 REVISION NUMBER:0 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE DL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSR WVD MM/ M X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 ❑ REE RENTED cert $100,000CLAIMS-MADE XOCCUR PREMISES ce MED EXP(Any one person) EXCLUDED A N N 9907993 01/182021 01/182022 PERSONAL&ADV INJURY $1,000,000 GEWL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,OW,ppp X POLICY [IJEI� ❑LOG PRODUCTS-COMP/OP AGG $2,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000 Ea acciden X ANY AUTO BODILY INJURY(Per person) A OWNED AUTOS ONLY SAUTOSCHEDULED N N 9907993 01/182021 01/182022 BODILY INJURY(Per acddern) HIRED AUTOS ONLY NON-OWNED PROPERTY DAMAGE AUTOS ONLY per X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $5,000,000 A EXCESS LIAB CLAIMS-MADE N N 9907994 01/18/2021 01/18/2022 AGGREGATE $5,000,000 DED I X I RETENTION WORKERS COMPENSATION OTH- ER X PER STATUTE AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE Y❑ E.L.EACH ACCIDENT $1,000,000 B OFFICER/MEMBER EXCLUDED? N/A N 9298530 01/18/2021 01/182022 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,10MOM If yes,describe order DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $1,000,000 I DESCRIPTION OF OPERATIONS I LOCATIONS!VEHICLES(ACORD 1(n,Addlional Remarks Sdtedie,may be attached if mwe space is,equred) CERTIFICATE HOLDER CANCELLATION 286-468-4 90 0 VILLAGE OF RYE BROOK SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 938 KING ST THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN RYE BROOK,NY 10573-1226 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE © 1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD YYORK Workers' CERTIFICATE OF STATE Compensation NYS WORKERS' COMPENSATION INSURANCE COVERAGE Board 1a.Legal Name&Address of Insured(use street address only) 1 b.Business Telephone Number of Insured ARCTIC MECHANICAL INCORPORATED 914-934-8301 460 N MAIN ST PORT CHESTER,NY 10573-3310 1c. NYS Unemployment Insurance Employer Registration Number of Insured Work Location of Insured(Only required if coverage is specifically limited to 1 d. Federal Employer Identification Number of Insured or Social Security certain locations in New York State,i.e.,a Wrap-Up Policy) Number 06-1596446 2.Name and Address of Entity Requesting Proof of Coverage 3a. Name of Insurance Carrier (Entity Being Listed as the Certificate Holder) Federated Reserve Insurance Company Village Of Rye Brook 938 King St 3b.Policy Number of Entity Listed in Box"I a" Rye Brook,NY 10573-1226 9298530 3c.Policy effective period 01/18/2021 to 01/18/2022 3d.The Proprietor, Partners or Executive Officers are ❑X included.(only check box if all partners/officers included) all excluded or certain partnerstofficers excluded. This certifies that the insurance carrier indicated above in box"3"insures the business referenced above in box"I a"for workers' compensation under the New York State Workers'Compensation Law. (To use this form, New York(NY)must be listed under Item 3A on the INFORMATION PAGE of the workers'compensation insurance policy). The Insurance Carrier or its licensed agent will send this Certificate of Insurance to the entity listed above as the certificate holder in box"2". The insurance carrier must notify the above certificate holder and the Workers'Compensation Board within 10 days IF a policy is canceled due to nonpayment of premiums or within 30 days IF there are reasons other than nonpayment of premiums that cancel the policy or eliminate the insured from the coverage indicated on this Certificate. (These notices may be sent by regular mail.)Otherwise,this Certificate is valid for one year after this form is approved by the insurance carrier or its licensed agent,or until the policy expiration date listed in box"3c",whichever is earlier. This certificate is issued as a matter of information only and confers no rights upon the certificate holder.This certificate does not amend, extend or alter the coverage afforded by the policy listed,nor does it confer any rights or responsibilities beyond those contained in the referenced policy. This certificate may be used as evidence of a Workers'Compensation contract of insurance only while the underlying policy is in effect. Please Note: Upon cancellation of the workers'compensation policy indicated on this form,if the business continues to be named on a permit,license or contract issued by a certificate holder,the business must provide that certificate holder with a new Certificate of Workers'Compensation Coverage or other authorized proof that the business is complying with the mandatory coverage requirements of the New York State Workers'Compensation Law. Under penalty of perjury, I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that the named insured has the coverage as depicted on this form. Approved by: DANIELLE SACKETT (Print name of authorized representative or licensed agent of insurance carrier) Approved by: J�t_iucll'&,ct4_r� 12/10/2020 (Signature) (Date) Title: AUTHORIZED REPRESENTATIVE Telephone Number of authorized representative or licensed agent of insurance carrier: 888-333-4949 Please Note: Only insurance carriers and their licensed agents are authorized to issue Form C-105.2. Insurance brokers are NOT authorized to issue it. C-105.2 (9-17) www.wcb.ny.gov